THE emergency department at Wrexham Maelor Hospital was “under siege” on the night a woman desperately ill with sepsis was kept waiting in an ambulance outside for over two hours, an inquest heard.

An internal investigation reported that with 56 people waiting to be seen, ambulances queuing outside and no beds available, the place was “in crisis”.

Samantha Brousas, 49, died less than 48 hours after she was finally admitted at about 5.40pm on February 21, 2018. The previous day her GP had diagnosed her as suffering from gastro-enteritis.

Miss Brousas, of Bron y Groes, Gresford, had been suffering with a cough since January but her condition had deteriorated over two or three days. She struggled to breathe and had a high temperature, and eventually an ambulance was called.

She arrived at hospital about an hour later and her daughter, medical student Sophie Brousas, and paramedics suspected she was suffering from sepsis. While waiting in the ambulance she was not triaged and did not receive antibiotics.

But Professor Solomon Almond, an independent consultant asked by Joanne Lees, assistant coroner for North Wales East and Central, to study the case, told the hearing in Ruthin that Miss Brousas was “destined to die” by the time she arrived at the hospital.

He said she had been weakened by flu and developed a secondary bacterial infection, and she survived so long merely because she had been so fit and well.

Her chances of survival would have been more than 50-50 if she had been taken into hospital that morning but her condition deteriorated rapidly.

The coroner asked: “Does it follow that irrespective of what happened after midday on February 21 your view is that on the balance of probability it’s unlikely Sam would have survived.”

Professor Almond replied: “That is my view.”

Earlier Dr Glyn Roberts, a senior manager on call that night, said that all three main hospitals in North Wales, at Wrexham, Bodelwyddan and Bangor, were under extreme pressure and nothing more could be done to ease the situation.

The “risk score” suggested that emergency department staff would be unable to perform even routine observations reliable, which meant that the unit was “under siege”.

Cross-examined by solicitor Stephen Jones, representing the Brousas family and Miss Brousas’ partner Simon Goacher, Dr Roberts accepted it had been a “unsafe, overcrowded” department.

He said that he was kept informed of the situation but was 70 miles away from the staff who had to take whatever measures they could.

“It’s difficult to think what else could have been done on that particular day,” he said.

Mr Dilip Menon, the on-duty consultant in emergency medicine, said it would have been possible to administer antibiotics to Miss Brousas in the ambulance but not before she had been clinically assessed.

The hearing continues and is due to conclude this week.